Individual
SAMANTHA ANN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6598 BRUSH ST, NORTH BRANCH, MI 48461-8842
(810) 610-9277
Mailing address
9414 FULMER RD, MILLINGTON, MI 48746-9703
(810) 610-9277
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4101006817
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4101006817
LLMFT
MI
Enumeration date
02/21/2019
Last updated
02/21/2019
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